Justicia Para El Pueblo Registration Form

Justice for the People | Justice for the Earth | Registration

Saturday, October 5, 2024 | 11am - 3pm
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address (this helps us know who lives in our communities)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you represent an organization?*

YesNo
What organization do you represent?*
Does this registration include more than one person?*

Yes! I will bring others with me.No, this is only for myself.
Total number of attendees in your group:*
Which parts of the event will you attend?*

The Earth FairThe Town Hall with free lunch provided
Please share any dietary needs or preferences.
Please share any language or translation assistance needed.
What environmental issues are you most concerned about? (check all that apply)

Air qualityWater qualityFloodingHeatTreesBiodiversityParks and green spacesEnergy equityFood securityGreenhouse Gas ReductionWaste managementEnvironmental racismOther
Should be Empty:

Justice for the People | Justice for the Earth | Registration